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General NPI Number Information
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NPI Number | 1235467333
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Entity Type | Organization
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Legal Business Name | MD HOMES INC
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Dates
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Enumeration Date | 12/01/2009
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Last Update Date | 12/01/2009
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Provider Practice Location Address
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Address Line | 708 W 14TH AVE
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City | GREENVILLE
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State | NC
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Zip | 27834-3083
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Country | US
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Telephone | 252-412-0353
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Fax | 252-822-0142
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Provider Business Mailing Address
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Address Line | 740 GREENVILLE BLVD STE 400-287
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City | GREENVILLE
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State | NC
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Zip | 27858-5135
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Country | US
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Telephone | 252-412-0353
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Fax | 252-822-0142
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Authorized Official
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Title or Position | DIRECTOR/CEO
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Name | MELISSA S JAMES
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Credential | BSN RN
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Telephone | 908-305-3143
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number |
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State | NC
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